VAJIRAM & RAVI [INSTITUTE FOR IAS EXAMINATION]

9-B, Bara Bazar Marg, Old Rajinder Nagar, New Delhi – 110 060

Tel. No. 25820000, 25734058, 43306017

Website: www.vajiramandravi.com

APPLICATION FORM UPSC Roll No.: _________________ (if received)

1. Name in Full: _________________________________ (in Block Letters) 2. Date of Birth: _________________________________

3. Father's Name: _______________________________

Occupation: __________________________________

4. Do you belong to SC/ST/OBC? (Yes / No)

(If yes, please mention the category) ____________________________

5. Permanent Address: _____________________________

_____________________________

_____________________________

6. Mailing Address _____________________________

_____________________________

_____________________________

Tel./Mobile No. _________________

7. E-mail Address _____________________________

8. Particulars of Educational Qualification ___________________________________________________________________ Examinations Name of College/ Year of Subjects Percentage of marks Passed University Passing Offered obtained ( Note: to be filled from 10th std )

___________________________________________________________________

Payment Details: Bank DD No.---------------- dated--------------

Bankers’ Name -------------------------------- Amount Rs.___________ P.T.O……

Staple THREE Passport

size photographs here

9. Have you appeared in the Civil Services ________________________________ Examination earlier?

If so, write the year and marks obtained: ________________________________

10. Mention subjects for which personal i) PRELIM-CUM-MAIN

guidance is required:

(a) General Studies Yes/No

(b) CSAT Yes/No

ii) MAIN EXAMINATION:

(a) General Studies: Yes/No

(b) Optional: -----------------

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11. Mention subjects for which postal MAIN EXAMINATION

guidance is required:

(a) General Studies: Yes/No

(b) Optional: -----------------

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Place: ______________ Signature of Applicant

Date: _______________

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FOR OFFICE USE ONLY

Admitted on _________________________ for_____________________________

Date:___________ ADMINISTRATIVE OFFICER COURSE DIRECTOR